Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Intro to D&D Midterm > Geriatrics Part 2 > Flashcards

Geriatrics Part 2 Flashcards

1
Q

when pharmacokinetic changes do not explain alterations to a drug response in a geriatric patient, what changes are assumed?

A

pharmacodynamic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which changes with aging are better understood – pharmacokinetics or dynamics?

A

pharmacokinetic changes are better understood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which are more VARIABLE -pharmacokinetic or dynamic changes with age?
explain

A

pharmacodynamic changes are more variable

changes in the:
-number of receptors
-sensitivity of receptors
-counter regulatory mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

give an example of drug receptors that INCREASE sensitivity with age

A

benzodiazepines and CNS depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

give an example of drug receptors that DECREASE sensitivity with age

A

beta-adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

geriatrics have _____ baroreceptor sensitivity

explain

A

decreased

leads to orthostatic hypotension - low Bp when standing and baroreceptors are not as sensitive - increases fall risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

name 3 drugs that can enhance the issue of orthostatic hypotension in elderly patients

A

tricyclic antidepressants
vasodilators
antihypertensives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

antipsychotics in elderly patients increases the risk of what?
is this a pharmacokinetic or dynamic effect?

A

increased risk of tardive dyskinesia and parkinsonism (rapid sudden movements)

pharmacodynamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

true or false

elderly patients have a decreased sensitivity to anticholinergic effects

A

FALSE - increased sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

elderly patients have ____ sensitivity to warfarin

A

increased (bc less albumin - more free drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

true or false

geriatrics have increased sensitivity of Na+, K+, ATPase

A

true

leads to increased toxicity to digoxin especially with low potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

explain the elderly response to ACE inhibitors and ARBS (angiotensin receptor blockers)

A

decreased response to them bc of decreased renin and aldosterone levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

geriatrics have an increased risk of hyperkalemia with what drugs?

A

NSAIDS
ACE inhibitors and ARBS (bc decreased response to them)
potassium sparing diuretics (spiranolactone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

explain how evidence-based prescribing is an important consideration in the older population

A

need to see what research has been done on the very old

not a lot of clinical trials on very old people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the saying for dosing an elderly patient on medication

A

start low, go slow, but don’t stop too soon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

a specific issue in older adults is whether or not we should bother treating a certain condition

give an example of this

A

treating dyslipedemia (high cholesterol) for primary prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

name 2 diseases that we treat less intensively in older adults

A

diabetes - don’t NEED below 7 A1C
hypertension - don’t treat too much - risk of orthostatic hypotension and falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

as time goes on, care changes from ____ to ____

A

curative to palliative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

as care changes from curative to palliative, what happens to the amount of appropriate medications?

A

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

_______ side effects are of particular concern in the elderly

A

anticholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the AGS Beers Criteria?

A

a list of potentially inappropriate medications for use in older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how many tables are in the 2023 updated Beers Criteria?

A

7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what medications are on table 2 in the Beers criteria

A

medications/classes that should be AVOIDED in persons 65 or older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what medications are on table 3 of the beers criteria

A

meds that should be avoided in older person with specific disease/syndrome

drug-disease interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what meds are on table 4 of beers criteria

A

meds that should be used with CAUTION in older adults

not enough info to be put on 2 or 3, but on radar

26
Q

what meds are on table 5 of beers criteria

A

potential important drug-drug interactions to avoid in geriatrics

27
Q

what meds are on table 6 of beers criteria

A

meds that should be avoided/lower dose in older people with decreased renal function

28
Q

what is on table 7 of beers criteria

A

meds with strong anticholinergic properties

29
Q

what is the fall risk factor that is most preventable and reversible?

A

medication use

30
Q

why are alpha blockers avoided in elderly?
name 2

A

increases fall risk

terazosin and doxasozin

31
Q

true or false

diuretics can increase fall risk

A

true - have to pee more, have to stand up fast, run to bathroom and fall

32
Q

____ or more CNS depressants can increase fall risk

A

3

33
Q

can antidepressants increase fall risk

A

yes

34
Q

say the pneumonic to remember anticholinergic side effects

A

dry as a bone
dry eyes, mouth

full as a flask
constipation, urinary retention

blind as a bat

mad as a hatter
delirium

tachycardia

35
Q

what can drugs with anticholinergic side effects do to heart rate

A

increase

36
Q

name 3 classes of drugs with strong anticholinergic properties

what Beers table are they on?

A

table 7

1st generation antihistamines (anything “pm” in OTC aisle)

phenothiazines

tricyclic antidepressants

37
Q

name 3 skin and connective tissue diseases commonly seen in geriatrics

A

arthritis
gout
glaucoma

38
Q

which type of arthritis is most common in older adults?

A

osteoarthritis

rheumatoid starts younger and is more systemic

39
Q

how are medications related to arthritis?

A

NSAIDS and opioids can cause/worsen arthritis in elderly patients

that’s why diclofenac is preferred as an NSAID bc it has no systemic side effects when applied topically

40
Q

when an elderly patient has gout, what is an important consideration?

A

possible renal issues

41
Q

name an issue with antibiotics in older adults

A

renal function is a big consideration in antibiotics renally excreted

42
Q

name the 3 most common infections in geriatrics

A

UTI
pneumonia
skin infections

43
Q

what symptoms may a geriatric patient experience when they have a UTI?

A

atypical symptoms like confusion and falls

their sensation for burning is not as strong

44
Q

what symptoms may a geriatric patient experience when they have pneumonia?

A

not typical symptoms like cough

may have similar to UTI like confusion and falls

45
Q

why are skin infections 1 of the 3 most common infections in geriatrics

A

elderly have thin skin

46
Q

what is the GOAL blood pressure for geriatric patients

why?

A

130/80
or less than 130, but not too low - concern with orthostatic hypotension

47
Q

what blood pressure medications should be avoided in geriatrics and why

A

alpha blockers - fall risk (terazosin/doxasozin)

beta blockers (for LONE htn) can be used if for afib

48
Q

name 4 favored agents for HTN for older adults

A

low dose diuretics
ACE inhibitors
ARBS
ca channel blockers (amlodipine)

49
Q

what is a side effect of calcium channel blockers that is a concern with the elderly

A

ankle swelling

50
Q

what is the most costly medicare diagnosis in the US

A

heart failure

51
Q

explain the treatment guidelines for heart failure for elderly patients vs younger patients

A

essentially the same - want to balance fluid overload vs dehydration

52
Q

in treating a heart failure patient, what are important things to monitor?

A

renal function and potassium levels

53
Q

what is a drug that is not 1st line for HTN

A

digoxin

have to monitor for toxicity - especially if low potassium - binds to same receptors

visual changes, nausea, anorexia, confusion

54
Q

true or false

digoxin is renally eliminated

A

true

55
Q

true or false

anticoagulants are contraindicated in the elderly

A

FALSE - age is not a contraindication

56
Q

in afib, an important consideration is controlling ____ vs controlling ____

A

rate vs rhythm

57
Q

in AFIB patients, anticoagulants are used to prevent stroke

which drugs are preferred

A

DOACS (direct oral anticoagulants) over warfarin

58
Q

why is treating dyslipidemia not really done in the elderly

A

few studies

risk-benefit for primary prevention: side effect of statins is muscle pain and this increases fall risk

59
Q

true or false

aspirin should be avoided for primary prevention in people over 60

A

TRUE - not secondary prevention tho (already had heart attack/stroke)

risk for bleeding

60
Q
A

Intro to D&D Midterm (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions